Finding link between certain foods, illness

Q: I have joint pain, but every time I eat brown rice, vegetables, fruits, or drink juices, I get worse. Can you tell me what causes it?

By DR. RAJESH BHAGAT

Q: I have joint pain, but every time I eat brown rice, vegetables, fruits, or drink juices, I get worse. Can you tell me what causes it?

A: Adverse reactions to food occur through a variety of mechanisms. The most notable and scientifically known is a reaction between allergy antibodies (produced by genetically predisposed individuals) and certain cells in the body.

This reaction results in production of chemicals that cause inflammation, involving various organs, and results in symptoms that alert to the possibility of allergic reactions. Food-related allergic reactions may include one or more of the following: itching, hives, throat closing, choking, difficulty breathing, diarrhea, vomiting, abdominal pain, a drop in blood pressure, heart arrhythmias and, in some cases, loss of consciousness and even loss of life. The cause of these reactions may be caused by nuts, eggs, milk, soy, seafood and other fish, wheat and more. The most common reactions involve the skin.

These reactions require production of allergy antibodies and are therefore called immunological food reactions and can be confirmed by immunologic tests.

Foods are known to cause reactions in other ways, as well. Reactions may be caused by toxins in foods — for example, in food poisoning. Certain additives in foods, such as sulfites, may cause symptoms that mimic allergic reactions, and chemicals in foods, such as tyramines and nitrites, may cause migraine-like symptoms in some individuals. These are known as non-immunologic reactions, because they do not involve antibodies.

To confirm the cause, such a reaction needs to be established by trial elimination of the suspected food, resulting in the disappearance of symptoms, and reintroduction of the food resulting in the return of the symptoms.

Physicians and patients alike have long been intrigued by the possibility that foods might provoke joint pain, arthritis and other rheumatic symptoms. It was thought that such reactions could occur through immunologic mechanisms, or by some unknown mechanisms that further enhance the inflammatory process in the joints and muscles.

So far, a specific immunologic mechanism between food consumption and joint pain, arthritis and muscles aches has not been established. Several scientific studies have been conducted to establish a relationship between foods and joint pain, muscle aches, etc. In these studies, an individual eliminated the suspected food for a length of time and then ate either a placebo (fake food) or the suspected food in an unrecognizable form, on separate days, and the results were recorded. Neither the observer nor the patient knew whether the patient received real or fake food. The results of these tests failed to establish cause and effect, although in very occasional individuals, the relationship between the two may be present. Such circumstances, however, are distinctly uncommon in these studies.

In summary, foods can cause reactions, caused by immunologic mechanisms in predisposed individuals and can be confirmed by immunologic tests. Such reactions usually involve the skin, gastrointestinal and cardio-respiratory systems. Foods can also cause reactions through non-immunologic mechanisms, which can be proven through trial elimination and reintroduction of foods, or through double-blind, placebo-controlled challenges.

Such challenges, which are considered the "gold standard" for evaluation of food-related symptoms, have not clearly established a relationship between food and joint pain, muscle aches, etc., except in a rare cases. In these cases, elimination of foods should improve symptoms. It is best to see a physician who can advise you on getting tested.